ksmedic202

Lordy that was funny....thank you for posting that....I needed a good laugh

Right after I had started my first job in full-time EMS, I got my first anaphylaxis call. Brand new medic( I hadn't had my cert very long, no excuse though). Our protocol was .3mg-.5mg of 1:1000 Epi SQ followed by .3mg-.5mg of 1:10000 Epi SQ if no relief. Well, I gave the first dose, and then gave the follow up dose of, yep you guessed it, 1:1000. No harm to the patient, but I was sick to my stomach. Recieved a verbal counsiling from my supervisor but no other penalty. Damn well better believe that I spend a lot of time reviewing my protocols even now, no matter how well I think I know them.

My wife knew what she was getting into. We dated while I was a volly so she got used to me having a pager and leaving at odd times. She likes to hear some of the "war" stories and got used to me having to be on call. When I started doing it full time, she got used to those hours quickly. She dosen't take an active role in talking about my job or understanding it sometimes, but she enjoys that I enjoy what I do.

Responed to a home for a "routine" psyche transport. A patient with suicidal ideations. Arrived on scene and the police inform me that not only is she suicidal, but she also threatened to stab her mother. Pt is a 14y/o female with a past history of Bi-polar. Went inside with police escort and tried to explain what was going to happen (ride nicely with the paramedic or ride nasty in handcuffs and various other restraints.) Apparently I was no so convincing and she assulted me (okay, she hit me in the arm as hard as an average 14y/o female can). I guess what I am trying to say is that I got beat up by a 14y/o girl for my first assult. How embarrassing. The police really put it to her, but to her credit she put up a good fight. I can laugh about it, you guys take it and roll with it if you want to.

It doesent happen very much here, so I was just wondering what others were doing in that same situation. We give report to the nurse and usually get a room assignment in the ER. Very rarely do I get told to send the patient to triage. I prefer to release the patient to an ER nurse and have her make the decision on placement. I realize that my nurses trust my report, but I feel they need to have "eyes on" the patient. As for PCR's, we are hospital based so our office is in our main recieving hospital. Write the report and place the original in the pt's file, a copy for us and a copy for our admin. If I am transferring a patient to an out of area hospital, then I complete the form and fax a copy of it back to the recieving hospital, speciffically to the floor where I dropped the pt off at.

I was just wondering how many services and/or techs release care of a patient to the Triage area? Do you release them to a nurse who evaluates them and then sends them to triage or do you release them strictly to the triage nurse to wait their turn.

I work for a small county service and when we do special event stand-by's we are also the transporting service. Granted, we don't have any large special events, but if we go to a local high school football game, if a player gets injured, we transport if needed. So yes, in my case, it is EMS.

Normally, the only time I use it is to check/confirm drug dosage. I do consult them if doing a peer orientated QA/QI, just to avoid any confusion. Now, the county service I work part-time for has a yearly protocol test, so I usually review those since I don't work under them on a consistent basis.

Former Navy corpsman. Corps school in San Diego and then on to Portsmouth Naval Hospital.(the old one, not the nice new one)

Richard B- I was a corpsman in the mid-90's. At that time if you wanted to work in the medical field in the USN as enlisted personnel, you went to Corpsman "A" school where you recieved your basic core insturction (no pun intended). After that, you recieved your first set of orders. Many of the specialties, i.e. x-ray, ortho tech, respiratory tech, required admission to a "C" school (C school, in the navy-haha-sorry) or an extended period of OJT. Many of the "C" schools had some sort of basic requirement to get in (think pre-reqs). Corpman "A" school consisted of the EMT-b ciricula and clinical setting ciricula. I went to class 5 days a week, 8 hours a day for 3-4months. On the downside, I did not recieve any NREMT credit for my class, which followed the NREMT ciriculum. I am sure that has changed now. Your basic corpsman after completion of corps school was corpsman-0000 (quad-0 in lay speak). Completion of OJT or "C" school would earn the corpsman a different designator. My favorite was corpsman-8404 or field medic. These corpsman went from corps school to Field med where they did an additional 8 weeks of intensive training with the USMC. You could then be deployed with Marine units as a medic. As it was a general time of peace in the world back then, I didn't get that opportunity. I would imagine that has changed today. Clear as mud? Hope I could help.

it is smaller than the the combitube in both width and lenth. Kind of an overgrown ET tube.

Coming from Kansas, I can say that a 2 vs 4 yr degree means very little, esp when it comes to financial decisions. All paramedic programs in Kansas have or are converting to a 2 year degree ( as a lot of them were certification programs in the past, this is a huge step for us). I work for the Federal Government as a GS-7 paramedic with a 2year degree, I make approx. $45,000 per year, same as I would make if I have a 4 year degree. This is probably the best paying job in the state. With time in grade I will probably max out at $60,000 per year. Four year degree medics here trend toward management. Once you factor in the huge rural population here and the shortage of EMS personnel, you can begin to see why. Street time and a 4 year degree will get you a management position here because you are the best qualified due to lack of choice. Even in our more urban areas i.e. Topeka, Wichita, and Kansas City, many medics are of the 2 year degree type. How they progress I cant really say, but management postions there are a little harder to come by. On a side not, if we are absorbed by the the fire dept. where I work, my 2 year degree will have me in a comparble salary bracket to several assistant directors/directors in the state. This is just regular shift work with no overtime.

I believe you need to have some experience with pre-hospital patient care before you go on to be a paramedic (or as Kansas calls them Mobile Intensive Care Technicians...anybody else call them that??) Personally, I have noticed that those who went staight from EMT-B to paramedic had a more difficult time becoming comfortable with a patient in the back of the rig. I honestly believe that it is because they don't have the experience working with patients in that setting. I see it everyday where I work. A ton of Nationally Registered EMT's who are absolutely lost on a call. I had the longest internship in my state at the time I went through at 720 hours with 3 years of being an EMT for a small service. Those of us that had this previous experience had a much easier time adapting to the application of our paramedic knowledge. Clinicals and internship is the time to begin using this new information in a practical setting/situations. Not the time for starting from square one.

When I was in internship, the LMA was referred to as the "Last Medical Adjunct". It was not thought highly of in the prehospital setting. It now seems to be gaining popularity. I don't know much about them, all the services I have worked for don't use them. The county service I work for carries the the old EOA's and a surgical crich kit with protocol similar to the one mentioned earlier. The other service I work for carries the combi-tube and a large bore needle crich kit. We looked at the King tube awhile back but have not made a decision yet. I guess what I am trying to say is for my service, its the combi-tube